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Cystic fibrosis presenting with recurrent vomiting and metabolic alkalosis
P M Mathew1, J A Hamdan, H Nazer
1Department of Paediatrics, Dhahran Health Centre, Saudi Arabia.
Insights
Cystic Fibrosis (CF) affects Saudi Arabian children, with an incidence of 1 in 4243. Early diagnosis is crucial, especially in infants presenting with hypoelectrolytaemia and metabolic alkalosis, even without chest symptoms.
Area of Science:
- Pediatrics
- Medical Genetics
- Public Health
Background:
- This study investigates the incidence and presentation of Cystic Fibrosis (CF) in Saudi Arabian children.
- Data was collected from healthcare facilities of the Saudi Arabian Oil Co. (Saudi Aramco) in the Eastern Province between 1980 and 1987.
- Understanding CF prevalence in specific populations is vital for public health strategies.
Observation:
- Ten Saudi Arabian children were diagnosed with Cystic Fibrosis (CF) during the study period.
- The calculated incidence of CF in Saudi children aged 14 years or younger was 1 in 4243.
- A significant proportion (50%) of diagnosed children presented with hypoelectrolytaemia and metabolic alkalosis.
Findings:
- Two of the five children with hypoelectrolytaemia and metabolic alkalosis initially showed no respiratory symptoms, presenting primarily with recurrent vomiting.
- These findings highlight a subset of CF patients where initial presentation may be non-respiratory.
- The study underscores the importance of considering CF in the differential diagnosis of unexplained electrolyte imbalances in children.
Implications:
- Early exclusion of Cystic Fibrosis (CF) should be considered in the diagnostic workup for infants presenting with hypoelectrolytaemia and metabolic alkalosis.
- This approach can lead to earlier diagnosis and intervention, potentially improving patient outcomes.
- Healthcare providers should maintain a high index of suspicion for CF in pediatric patients with these metabolic derangements, irrespective of respiratory signs.
Abstract:
Between January 1980 and December 1987, ten Saudi Arabian children at Saudi Arabian Oil Co. (Saudi Aramco) health care facilities in the Eastern Province of Saudi Arabia had cystic fibrosis (CF). The incidence of CF in Saudi Arab children less than or equal to 14 years was 1 in 4243. Five of the ten children had hypoelectrolytaemia and metabolic alkalosis on initial presentation. Two of the five had recurrent vomiting, hypoelectrolytaemia and metabolic alkalosis alone and initially no chest symptoms. Early exclusion of CF should be part of the workup in any child, especially in an infant with hypoelectrolytaemia and metabolic alkalosis.